Final Flashcards
(155 cards)
1
Q
The shoulder should not be abducted more than _________ to maintain neutral posture.
A
30 degrees
2
Q
When transporting a patient in a wheelchair, what is the first thing we should do when they’re ready to get on the bed?
A
Lock the wheels
3
Q
Describe the difference between subcostal and intercostal.
A
Subcostal: underneath the ribs
Intercostal: in between the ribs
4
Q
What is the anatomical landmark to locate the pancreas?
A
Xyphoid process
5
Q
What separates the thoracic and abdominal cavities?
A
The diaphragm
6
Q
What is the muscle of respiration?
A
The diaphragm
7
Q
What are the most and least common patient positions?
A
Most common: supine
Least common: prone
8
Q
List and describe some proper ergonomic practices you can utilize as a Sonographer to insure that you don’t injure yourself in the field.
A
- Keep a neutral posture to minimize straining the shoulders/back/neck and
- Grip the transducer lightly to avoid straining the wrist
- Position the patient appropriately so we are not reaching over uncomfortably or misaligning our posture
- Take breaks when necessary and allow muscles to recover properly by standing/sitting/stretching the body
- Adjust workplace/ultrasound station to ensure wires are not touching the floor, adjust patient table, and adjust chair position if needed
9
Q
Which scan plane is horizontal across the patient’s body, or 90 degrees to the sagittal plane?
A
Transverse
10
Q
Define ALARA.
A
As Low As Reasonably Acheivable
11
Q
Define A mode, B mode, and M mode.
A
A mode: amplitude mode; one dimensional, height of spikes represents strength of returning echo (displays ultrasound signals as peaks on a graph representing depth and amplitude, usually used to determine thickness)
B mode: brightness mode; gray scale shadings represent strength of the echo (2D grayscale imaging that displays a structure with ultrasound echoes, this is used to visualize most anatomical structures)
M mode: motion mode; combination of A and B modes, showing gray scale structures in motion (displays changes in echo signals over a period of time to visualize moving structures, such as heart imaging)
12
Q
What is the ARDMS? What is its significance?
A
American Registry for Diagnostic Medical Sonography
Independent, non-profit organization that administers registry examinations and awards credentials in areas of ultrasound
Important for licensing, accreditation, and where we pay our yearly dues to
13
Q
What does SPI stand for?
A
Sonographers Principles and Instrumentation
14
Q
When would we take the SPI exam?
A
Before sitting for our registry examinations
15
Q
What is the SDMS? What is its significance?
A
Society of Diagnostic Medical Sonography
Establishes the code of ethics for the field and our scope of practice to keep the integrity of our practice intact
One of the largest societies
16
Q
What is Aium? What is its significance?
A
American Institute of Ultrasound in Medicine
The place an ultrasound technician works at must be accredited every 3 years, which is followed through by this organization
Makes sure the workplace is up to standards
17
Q
What is the scope of practice?
A
- Perform patient assessments
- Acquire and analyze data obtained using ultrasound and related diagnostic technologies
- Provide a summary of findings to the physician to aid in patient diagnosis and management
- Use independent judgement and systematic problem solving methods to produce high quality diagnostic information and optimize patient care
18
Q
What leads to work related MSK injury?
A
Repetitive motion, bad posture, poor ergonomics of ultrasound station
19
Q
Rank the lowest power setting to the highest power setting.
A
M-mode –> B-mode –> Pulsed Doppler
20
Q
What are the three steps you need to follow when adjusting your image once you first begin scanning?
A
Depth, Focus, Gains
21
Q
What does Continuous Wave Doppler measure?
A
Blood flow velocity
22
Q
What mode will we use the most while scanning? Why?
A
B mode; provides a detailed visualization of an anatomical structure or any abnormalities in real time, yet is the most basic gray scale image we can obtain
23
Q
Define pulsed Doppler.
A
Provides measurement of changing velocity of blood flow, used to assess blood flow in arteries/veins
24
Q
Define color Doppler.
A
Overlays color information over B mode, indicating blood flow (arteries vs veins) to a structure and the speed/direction of blood flow through a vessel
25
Define power Doppler.
More sensitive than color doppler, showing a greater detail of blood flow which may not be picked up by color doppler
ONLY provides information on blood flow, no direction
26
What are the 3 principles of the code of ethics? List one example for each principle.
1. Promote patient well being/protect the patient: provide information, answer patient questions, protect patient confidentiality
2. Be competent: don't perform an exam we don't know how to, become educated, maintain credentials
3. Demonstrate integrity: be honest, avoid conflicts of interest, communicate
27
When are legal restraints used?
When the patients safety is at risk
28
When might a sonographer have a part in a patient signing a consent form?
As a witness when the doctor would like to perform a biopsy
29
What are examples of non-verbal comunications?
Facial expression, movement, eye contact, gesture, touch
30
When there is a language barrier, what are we able to utilize to help communicate with a patient?
A medical interpreter
31
What is an NG tube?
Naso-gastric tube; inserted through nasal cavity down the esophagus into the stomach to administer food/medication
32
What is a nasal cannula?
Plastic tube with two prongs that are superficially inserted into the nose to deliver oxygen
33
What is used to deliver oxygen to a patient?
In-room piping systems, oxygen tanks, and cylinders
34
What is something to keep in mind while scanning someone using supplemental oxygen?
They may not be able to take a deep breath and hold it for long or at all
35
What is the most common urinary catheter?
Foley catheter
36
What can we do to minimize the spread of infection?
1. Keep the scanning environment clean (exam beds, machine, transducer) by using disinfectant wipes in between patients.
2. Washing hands in between patients with warm soap and water for 20 seconds.
3. Wearing appropriate PPE (gloves usually and gowns, face shields, and masks when necessary).
37
If the patient is a fall risk and needs to use the bathroom, what can we do?
We'd only be able to give them a bedpan or call their nurse to help them use the bathroom
38
What are 5 sonographer do's? 5 don'ts?
Do's:
1. Question things that don't make sense
2. Explain procedures and expectations to the patient
3. Work with care
4. Maintain records and documents
5. Practice within our skill set
Don'ts:
1. Non-compliant with HIPAA
2. Fail to meet safety precautions
3. Have an unkempt work station/you yourself are unkempt
4. Be disrespectful
5. Not adhering to proper protocol
39
Do sonographers have malpractice insurance?
No, we would be covered under the provider
If we do everything we need to do/are expected to do, we're "covered". Otherwise, if e do something wrong, malpractice insurance will not cover us.
40
Define assault.
A threat that results in fear (does NOT always mean physical contact)
41
Define battery.
Unlawful touching without consent with or without injury
42
Define invasion of privacy.
Release of confidential information to the public that results in humiliation and/or mental suffering
43
Define false imprisonment.
Restraining a patient without permission
44
Define slander vs libel.
Slander is spoken defamation, whereas libel is written defamation
45
How would we document a suboptimal study if a patient is unable to move per doctors orders?
Limited study secondary to limited patient mobility
46
What is negligence?
Unintentional misconduct
47
Define sonographer duty vs breach of duty.
Duty: perform studies within most up-to-date standard of practice
Breach of duty: failure to exercise reasonable care
48
Define cause and injury in regards to negligence.
Cause: injury as a direct result of negligence
Injury: any hurt a patient sustains as a result of negligence
49
How would you guide a visually impaired patient?
Ask if you can guide them physically, make sure there is a clean walking path for them, guide them back to the waiting room/wherever they go after the appointment
50
What are the stages of grief in order?
1. Denial
2. Anger
3. Depression
4. Bargaining
5. Acceptance
51
What does LESSN stand for?
Location
Echogenicity
Size
Shape
Number
52
Match the terms on the left to their suffixes on the right.
1. abnormality A. oma
2. surgical correction B. iasis
3. incision C. pathy
4. tumor D. itis
5. condition E. genic
6. inflammation F. plasty
7. origin G. tomy
8. pain H. oid
9. like I. ectomy
10. surgical removal J. scopy
11. blood condition K. centesis
12. inspection L. algia
13. puncture M. emia
1. C
2. F
3. G
4. A
5. B
6. D
7. E
8. L
9. H
10. I
11. M
12. J
13. K
53
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
54
What are the 5 major components of the patient bill of rights?
1. The right to information about healthcare options
2. The right to make decisions regarding your healthcare
3. The right to transparency of medical cost and quality of care
4. The right to quality medical care
5. The right to privacy and data confidentiality
55
What are CMEs? How many do we need to remain in good standing with the ARDMS?
Continuing Medical Education; we need to complete 30 CME credits every 3 years
56
How many CME credits are registry exams worth?
15 credits
57
Who do we pay annual renewal fees to as a registered sonographer?
ARDMS
58
When we see a scalloped liver border and/or areas of surrounding fluid, what is it most likely indicative of?
Cirrhosis
59
What is a paracentesis?
A procedure to drain excess fluid from the abdominal area to relieve pain and bloating
60
Name who can be in the loop regarding patient confidentiality.
Those who are directly involved with the patients care (doctors, nurses, PAs, sonographers, MAs, radiologists), insurance companies to help patients pay for exams and us.
Friends and family are allowed to be in the loop only if the proper consents have been filled out.
61
Who has to follow HIPAA?
Health plans, health care providers, and health care clearinghouses are considered covered entities, however also includes 3rd party business associates who operate under a covered entity (billing company, legal consultants)
62
Give examples of the types of information protected by the HIPAA privacy rule.
Name, DOB, SSN, MRN, address, health insurance information, patients medical health records, any results/reports, visit summaries, communications between the office/provider and the patient
63
T or F..........The Patient's Bill of Rights is that patients deserve to be treated with respect, dignity, and kindness as well as be involved in their care.
True
64
What could happen if you violate HIPAA?
Termination of your position, lawsuit, risk losing your license
65
What is a Cholelithotripsy?
Utilization of shock waves to break gallstones apart
66
What is a Coronary angiography?
A medical imaging procedure that evaluates the coronary arteries of the heart
67
Introduction of a fiberoptic instrument through the abdominal wall for diagnostic purposes is called a...
Laparoscopy
68
Dysphagia describes difficult, painful or abnormal...
Swallowing
69
Cholangioenterostomy describes a procedure that...
...surgically creates a passageway between the gallbladder duct to the intestine
70
What causes work-related musculoskeletal disorders?
Force (grip, downward pressure)
Repetitive motion (back, hand, fingers, wrist)
Awkward posture/father from neutral posture
71
What is a drug?
A substance that alters biologic activity
72
What makes a drug therapeutic?
Dosage
73
Describe an adverse vs allergic reaction.
Adverse reactions are an undesired reaction to a medication (drowsiness, headache, dry mouth), but can be life threatening (excessive bleeding).
An allergic reaction is categorized by a rash, itching, swelling, difficulty breathing, wheezing.
74
List the 6 methods of drug delivery.
1. Oral
2. Topical
3. Sublingual
4. Inhalation
5. Injection
6. Intravenous
75
What is the quickest way for a drug to be delivered into our system?
Intravenously
76
List and describe the 3 kinds of injections (not IV).
1. Intradermal: 10-15 degree injection angle
2. Subcutaneous: 45 degree injection angle
3. Intramuscular: 90 degree injection angle
77
What are the disadvantages of subcutaneous vs intramuscular injections?
Subcutaneous: irritation
Intramuscular: short shelf life, discomfort for elderly
78
When a provider is preparing to perform a biopsy, how can a sonographer help?
1. Confirm medication is not expired
2. Confirm it is the correct medication that the provider needs
3. Measure area for depth to help the provider decide what gauge needle to utilize
79
What if we find an unconscious patient or they become unconscious in our care?
Call 911 or assign someone to call 911, assess surroundings, listen for breath sounds, and feel for a pulse prior to beginning compressions & rescue breaths after clearing their airway with a finger in their mouth
80
How can we prevent injuring ourselves on the job?
Proper workstation setup, stretching/moving during breaks, taking breaks, eating healthy, exercising, posture awareness
81
Define hypersensitivity.
an exaggerated response to something that is normally harmless, however manifests as localized or systemic inflammation
82
Define idiosyncratic.
An abnormal or unusual effect from a medication that is not normally seen in people. Idiosyncrasies are unique to an individual i.e.having a headache after eating a certain type of food
83
Define iatrogenic.
State of illness/adverse effect caused by medical treatment, i.e. a doctor prescribes steroids for long-term use, then the patient develops Cushing's syndrome
84
Define tetratogenic.
Refers to substances that can cause birth defects /developmental abnormalities in a fetus, i.e. accutane, alcohol, tobacco use.
85
Define drug interaction.
When the effect of a drug being taken is altered by another substance (drug, food, supplements) or if the patient has certain medical conditions
86
What is the difference between a brand vs generic drug?
The brand is an identifying name in association with the company that makes the drug, the generic is not associated with any company and the name is inclusive of its active ingredient. Both drugs will include the same active ingredient.
87
What are the differences of CPR technique with adults vs children vs infants?
1. Adult: Check for a pulse using the carotid artery. 30 compressions to 2 breaths, compressions should extend 2 inches deep using 2 hands and make sure to tilt the head back to open the airway. Call 911 after doing CPR for a minute.
2. Child: Check for a pulse using the carotid artery. Most techniques for those aged 1-7 years old are similar for an adult (30 compressions to 2 breaths), however it is recommended to begin CPR immediately on a child even before calling for help. If alone, we call 911 after 5 cycles of compressions/breaths and consider AED with pediatric pads if available. Compression depth should be about 1.5 inches using 1-2 hands and we should make sure to avoid tilting the head back as much as an adult to prevent blocking the airway.
3. Infant: Gently stroke the baby or tap its foot to assess consciousness. Begin CPR immediately and if possible assign someone else to call 911 while performing CPR. Check for a pulse on the upper arm. Tilt head back very minimally as if they are sniffing the air to avoid damage to the airway. Use 2 fingers to compress 1-1.5 inches deep.
88
Define BLS.
Basic Life Support (it is a certification)
89
What are examples of demographics?
Basic information about the patient, including their full name, DOB, age, phone number, and insurance
90
Define signs vs symptoms.
Signs are objective (what you can see) and symptoms are subjective (what you feel)
91
What is the HPI?
History of Present Illness; details the patients symptoms that caused them to seek medical attention
92
What is the assessment and plan?
Written sum of likely cause of patients symptoms and action that will be taken
93
What is a CPT vs ICD code?
CPT = procedure code
ICD = diagnosis that are needed for CPTs
94
Are medical records sent with a claim?
No, however it can be upon request (only the bare minimum of information)
95
What imaging modalities use contrast media to enhance structures being imaged?
Xray, CT, MRI, nuclear imaging, Ultrasound
96
What are examples of contrast agents?
Barium, Iodine, Gadolinium, and micro-bubbles that are for ultrasound
97
What are we concerned of when considering imaging that requires contrast?
Whether the patient has poor kidney function
98
How are microbubbles administered for ultrasound?
IV
99
What does MRI stand for?
Magnetic Resonance Imaging
100
What does CT stand for?
Computed tomography
101
If we have to make a correction to a patients chart, what are we supposed to do?
Draw a single line through what is incorrect, explain yourself/correct the statement, and date when corrrected
102
What are some of the ways contrast agents are administered to the patient?
IV, orally, rectally, arterially
103
Hematosalpinx is a term describing...
blood in fallopian tube
104
Surgical reconstruction of the vagina would be termed...
colpoplasty
105
Oligomenorrhea refers to...
scanty, less than normal menstrual flow
106
Mammoplasty refers to...
surgical reconstruction of a breast
107
Difficult, complicated labor and delivery is termed...
dystocia
108
A patient requires surgery to restore and reattach the uterus back in its normal anatomical position because of uterine prolapse into the vagina. This procedure is termed...
hysteropexy
109
Surgical repair of hypospadias using the foreskin of the head of the penis would be termed...
balanoplasty
110
Cancer of the testicle usually requires its surgical removal. This procedure is termed...
orchidectomy
111
A hydrocele defines...
a clear fluid filled sac partially surrounding the testis
112
A surgical procedure performed to relieve partial obstructions of the male urethra due to an enlarged gland at the base of the bladder is called...
TURP
113
Cryptorchidism refers to...
an undescended testicle (not in the scrotum)
114
A male with testosterone deficiency may most likely be treated with which of the following agents to restore and maintain normal sexual function?
androgenic
115
Surgical implantation of an undescended testicle into the scrotum and anchoring it in its correct anatomical position is termed...
orchidopexy
116
Inflammation of the head of the penis is termed...
balanitis
117
T or F..... Medical records are not a legal document and are not subject to the state or country in which they were produced.
False
118
If the tumor is primarily made of glandular tissue, it would most likely have which of the following word parts associated with it?
Adeno-
119
If the patient were diagnosed with endocarditis, what would be the location of the infection?
The innermost layer of the heart
120
Write a short history of the development of Ultrasound from the 50's to 2000's.
50's: An OB named Ian Donald began using ultrasound techniques for prenatal imaging to detect fetal abnormalities + track fetal growth
60's: Pulsed Doppler system was established by Donald Baker to assess vascular flow
70's: Grey scale imaging was introduced, expanding the application of US to ABD, MSK, and cardiac imaging
80's: 3D ultrasound was developed with the rise of computerized technology, f1st being used in fetal studies
90's: 4D ultrasound technology established, which incorporated both real-time movement with 3D ultrasound to have the most optimal visualization of organs within the body
2000's: Adaptation of wireless machine technology and further advancements were made to 3D + 4D technologies
121
A recording of the electrical activity of the heart is termed...
Electrocardiogram (ECG/EKG)
122
Permanent damage to heart muscle due to a blocked artery is termed...
Myocardial infarct
123
Gallstones within a fluid-filled gallbladder appear...
Echogenic
124
Your patient is having a RUQ ultrasound and you notice that in the right lobe of the liver you see a fluid filled structure that is separate from the GB. Since you know that sound travels through a fluid-filled substance and is not attenuated, this image would demonstrate...
Enhancement
125
A "dirty" shadow usually is caused by:
Air in the duodenum/small intestine
126
How does the fetus obtain oxygen and nutrients and dispose of carbon dioxide and wastes during the last trimester of pregnancy?
Through the maternal connection via the umbilical cord as the fetal lungs are not functional before birth
127
A funnel shaped reservoir that collects urine from all parts of the kidney is the...
Renal pelvis
128
Which of the following types of tissues forms continuous sheets that serve as linings?
Epithelial
129
The study of factors that cause or encourage disease is which one of the following?
Epidemiology
130
Any plane parallel to the median plane.
Sagittal
131
A vertical plane that bisects the body into right and left halves.
Median
132
Any plane at right angles to both the median and coronal planes.
Transverse
133
Any vertical plane at right angles to the median plane.
Coronal
134
Which component of the lymphatic system produces WBC's?
Bone marrow
135
A thin, double membrane surrounding organs of Abdomino-pelvic cavity is called the...
Peritoneum
136
The right renal artery passes ________ to the IVC to reach the right kidney.
Posterior
137
Which of the following best describes systemic circulation?
Blood flow to and from the cells and tissues of the body, but not including the lungs
138
A line parallel on the middle of the sternum and the xyphoid process is known as the...
Midsternal line
139
Estrogen is secreted by _____, whereas progesterone is secreted by the _____.
Follicles; corpus luteum
140
What are the 4 vital signs? What else is taken with vital signs?
Heart rate, temperature, respiratory rate, oxygen saturation. Other measurements that can be taken are blood pressure and weight.
141
Define ABI. Why is ABI significant in vascular sonography? What is the normal measurement?
Ankle-brachial index, normal measurement is > or = to 1. Helps to assess severity of peripheral artery disease.
This is the ratio of systolic blood pressure at the ankle vs at the arm.
142
A pregnant patient who is 8 months along suddenly begins to feel sweaty and dizzy during her ultrasound. What caused this and how can we help the patient?
Due to IVC compression while the patient is laying down, dropping their blood pressure and causing these symptoms.
If this happens, we want to reposition the patient by turning them over to the side (not sitting up since they may faint). We want to make sure that before the patient leaves, her blood pressure returns back to normal.
143
A blood pressure cuff should have about ____% overlap around an arm.
20
144
If you fail to perform studies that are up to date with the current standard practices, what can this be labeled as?
Intentional misconduct
145
What are the most basic needs for life?
Food, shelter, clothing
146
What happens if a patient is unconscious but you need to gather a consent?
If the patient is in need of care and cannot consent, implied consent is used to provide proper care for the patient
147
How can we avoid injury in sonography?
1. Take breaks
2. Manage stress
3. Adjust equipment
4. Stretch
5. Exercise
6. Sleep well
7. Eat healthy
148
What information should we provide the patient when they're coming in for a study?
1. If there is any preparation i.e. no food/water for 8 hours prior to abdominal study
2. Time and date of exam
3. Answer any questions
149
What factor is the largest contributor to sonographer injuries?
Awkward or static posture
150
How do ethics and morality relate?
Ethics is the philosophical study regarding moral principles, however morality refers to a group of personal/societal principles to define what is right or wrong.
151
Presence of a kidney stone is termed...
Nephrolithiasis
152
Nephrolithotomy is the term for...
Removing kidney stones
153
Refers to tissue "graininess"
Texture
154
Tissue particles are large and spaced out
Coarse
155
Tissue particles are small and close together
Fine
